| NPI | 1922399468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A157959) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-131097) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35-131097) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2018-09-25 |